Original Research| Volume 35, ISSUE 5, P372-380, June 2012

Download started.


Chiropractic Care of Children from Birth to Adolescence and Classification of Reported Conditions: An Internet Cross-Sectional Survey of 956 European Chiropractors



      Few studies have addressed the practice of chiropractic care of children in Europe. No systematic classification of conditions currently exists in chiropractic pediatrics. The objective of this study was to investigate characteristics of clinical chiropractic practice, including the age of pediatric patients, the number of reports of negative side effects (NSEs), the opinions of doctors of chiropractic on treatment options by patient age groups, the conditions seen and the number of treatment sessions delivered by conditions and by patient age.


      An Internet cross-sectional survey was conducted in 20 European countries with 4109 doctors of chiropractic invited to reply. The 19 national associations belonging to the European Chiropractic Union and the Danish Chiropractic Association were asked to participate. Respondents were asked to self-report characteristics of their practices.


      Of the 956 (23.3%) participating chiropractors, 921 reported 19821 pediatric patients per month. Children represented 8.1% of chiropractors' total patient load over the last year. A total of 557 (534 mild, 23 moderate, and 0 severe) negative (adverse) side effects were reported for an estimated incidence of 0.23%. On the given treatment statements, chiropractors reported varying agreement and disagreement rates based on patient age. The 8309 answers on conditions were grouped into skeletal (57.0%), neurologic (23.7%), gastrointestinal (12.4%), infection (3.5%), genitourinary (1.5%), immune (1.4%), and miscellaneous conditions (0.5%). The number of treatment sessions delivered varied according to the condition and the patient age.


      This study showed that European chiropractors are active in the care of pediatric patients. Reported conditions were mainly skeletal and neurologic complaints. In this survey, no severe NSEs were reported, and mild NSEs were infrequent.

      Key Indexing Terms

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Manipulative & Physiological Therapeutics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Leboeuf-Yde C
        • Hennius B
        • Rudberg E
        • Leufvenmark P
        • Thunman M
        Chiropractic in Sweden: a short description of patients and treatment.
        J Manipulative Physiol Ther. 1997; 20: 507-510
        • Lee AC
        • Li DH
        • Kemper KJ
        Chiropractic care for children.
        Arch Pediatr Adolesc Med. 2000; 154: 401-407
        • Sorensen LP
        • Stochkendahl MJ
        • Hartvigsen J
        • Nilsson NG
        Chiropractic patients in Denmark 2002: an expanded description and comparison with 1999 survey.
        J Manipulative Physiol Ther. 2006; 29: 419-424
        • Christensen M
        • Kollasch M
        • Hyland JK
        Practice analysis of chiropractic 2010. National board of chiropractic examiners, Greely, CO2010
        • Hestbaek L
        • Stochkendahl MJ
        The evidence base for chiropractic treatment of musculoskeletal conditions in children and adolescents: the emperor's new suit?.
        Chiropr Osteopat. 2010; 18: 15
        • Pohlman KA
        • Hondras MA
        • Long CR
        • Haan AG
        Practice patterns of doctors of chiropractic with pediatric diplomate: a cross-sectional survey.
        BMC Complement Altern Med. 2010; 10: 26
        • Nyiendo J
        • Olsen E
        Visit characteristics of 217 children attending a chiropractic college teaching clinic.
        J Manipulative Physiol Ther. 1988; 11: 78-84
        • Durant CL
        • Verhoef MJ
        • Conway PJ
        • Sauve RS
        Chiropractic treatment of patients younger than 18 years of age: frequency, patterns and chiropractor's beliefs.
        Paediatr Child Health. 2001; 6: 433-438
        • Rubin D
        Triage and case presentations in a chiropractic pediatric clinic.
        J Chiropr Med. 2007; 6: 94-98
        • Alcantara J
        • Ohm DC
        • Kunz DK
        The safety and effectiveness of pediatric chiropractic: a survey of chiropractors and parents in a practice-based research network.
        Explore (NY). 2009; 5: 290-295
        • Bablis P
        • Pollard H
        • Bonello R
        A retrospective analysis of self-reported symptoms from the 761 consecutive new patients presenting to a Neuro Emotional Technique chiropractic clinic.
        Complement Ther Clin Pract. 2009; 15: 166-171
        • Alcantara J
        • Ohm DC
        • Kunz DK
        The chiropractic care of children.
        J Altern Complement Med. 2010; 16: 621-626
        • Gotlib A
        • Rupert R
        Assessing the evidence for the use of chiropractic manipulation in paediatric health conditions: a systematic review.
        Paediatr Child Health. 2005; 10: 157-161
        • Gotlib A
        • Rupert R
        Chiropractic manipulation in pediatric health conditions—an updated systematic review.
        Chiropr Osteopat. 2008; 16: 11
        • Hawk C
        • Khorsan R
        • Lisi AJ
        • Ferrance RJ
        • Evans MW
        Chiropractic care for nonmusculoskeletal conditions: a systematic review with implications for whole system research.
        J Altern Complement Med. 2007; 13: 491-512
        • Hestbaek L
        • Jorgensen A
        • Hartvigsen J
        A description of children and adolescents in Danish chiropractic practice: results from a nationwide survey.
        J Manipulative Physiol Ther. 2009; 32: 607-615
        • Hayes NM
        • Bezilla TA
        Incidence of iatrogenesis associated with osteopathic manipulative treatment of pediatric patients.
        J Am Osteopath Assoc. 2006; 106: 605-608
        • Vohra S
        • Johnston BC
        • Cramer K
        • Humphreys K
        Adverse events associated with pediatric spinal manipulation: a systematic review.
        Pediatrics. 2007; 119: e275-e283
        • Miller JL
        • Benfield K
        Adverse effects of spinal manipulative therapy in children younger than 3 years: a retrospective study in a chiropractic teaching clinic.
        J Manipulative Physiol Ther. 2008; 31: 419-423
        • Humphreys BK
        Possible adverse events in children treated by manual therapy: a review.
        Chiropr Osteopat. 2010; 18: 12
        • Lim A
        • Cranswick N
        • South M
        Adverse events associated with the use of complementary and alternative medicine in children.
        Arch Dis Child. 2011; 96: 297-300
        • Phillips B
        Towards evidence based medicine for paediatricians.
        Arch Dis Child. 2005; 90: 1308-1309
        • Pedersen P
        • Breen AC
        An overview of European chiropractic practice.
        J Manipulative Physiol Ther. 1994; 17: 228-237
        • Gouveia LO
        • Castanho P
        • Ferreira J
        Safety of chiropractic interventions. A systematic review.
        Spine (Phila Pa 1976). 2009; 34: E405-E413
        • Hawk C
        • Schneider M
        • Ferrance RJ
        • Hewitt E
        • Van Loon M
        • Tanis L
        Best practice recommendations for chiropractic care for infants, children and adolescents: results of a consensus process.
        J Manipulative Physiol Ther. 2009; 32: 639-647
        • Gupta SK
        Update on infantile colic and management options.
        Curr Opin Investig Drugs. 2007; 8: 921-926
        • Canadian Paediatric Society
        Chiropractic care for children: controversies and issues.
        Paediatr Child Health. 2002; 7: 85-104